Reducing the risk of sensitivity and pulpal complications after the placement of crowns and fixed partial dentures.
Reducing the risk of sensitivity and pulpal complications after the placement of crowns and fixed partial dentures.
复制标题
降低安装牙冠和固定局部义齿后敏感和牙髓并发症的风险。
DOI：
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发表时间：
1996
影响因子：
1.9
通讯作者：
M. Brännström
中科院分区：
文献类型：
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作者：
M. Brännström
用玻璃离子粘固剂粘固牙冠后的敏感性通常归因于粘固剂对牙髓的不利影响。目前常用的大多数永久性修复材料不倾向于刺激牙髓;牙髓损伤的主要原因是感染，细菌起源于玷污层或牙小管深处，龋齿挖掘程序无法进入。一个不合适的临时冠可能会使切割的牙本质暴露在口腔液中，并且在准备过程中由摩擦热引起的机械创伤也可能损坏牙髓。在预粘固过程中，建议采取以下预防措施，以降低牙髓炎症反应的风险：（1）临时冠应贴合良好，覆盖颈部牙本质，但不撞击牙周组织。永久冠应尽快粘固。(2)在放置临时冠之前，应去除表面玷污层，并用抗菌溶液处理牙本质表面。(3)为了减少临时冠下的牙本质渗透性，牙本质表面应该覆盖一个衬里，在最终粘固之前可以很容易地去除。(4)为了确保最佳的微机械结合，牙本质表面应该彻底清洁，并且牙本质应该保持湿润直到粘固。(5)在进行牙冠粘固之前，应仔细检查咬合情况。
Sensitivity after cementation of a crown with glass-ionomer cement is often attributed to an adverse effect on the pulp by the luting agent. Most permanent restorative materials in common use today do not tend to irritate the pulp; the main cause of pulpal damage is infection, the bacteria originating in the smear layer or deep in the dental tubules, inaccessible to caries-excavating procedures. A poorly fitting provisional crown may expose cut dentin to the oral fluids, and mechanical trauma caused by frictional heat during preparation may also damage the pulp. The following precautions are recommended during precementation procedures to reduce the risk of an inflammatory response in the pulp: (1) The provisional crown should be well fitting, covering cervical dentin but not impinging on the periodontal tissues. The permanent crown should be cemented as soon as possible. (2) The superficial smear layer should be removed and the dentinal surface should be treated with an antibacterial solution before the provisional crown is placed. (3) To decrease dentinal permeability under the provisional crown, the dentinal surface should be covered with a liner that can be easily removed before final cementation. (4) to ensure optimal mircomechanical bonding, the dentinal surface should be thoroughly cleaned, and the dentin should be kept moist until cementation. (5) The occlusion should be carefully checked before cementation of the crown.